International Journal of

Environmental Research
and Public Health

Article
Corona Virus (COVID-19) “Infodemic” and Emerging
Issues through a Data Lens: The Case of China
Jinling Hua and Rajib Shaw *
Keio University, Fujisawa 252-0082, Japan; hana@sfc.keio.ac.jp
* Correspondence: shaw@sfc.keio.ac.jp




Received: 13 March 2020; Accepted: 25 March 2020; Published: 30 March 2020


Abstract: Coronavirus (COVID-19) is a humanitarian emergency, which started in Wuhan in China in

early December 2019, brought into the notice of the authorities in late December, early January 2020,
and, after investigation, was declared as an emergency in the third week of January 2020. The WHO
declared this as Public Health Emergency of International Concern (PHEIC) on 31th of January
2020, and finally a pandemic on 11th March 2020. As of March 24th, 2020, the virus has caused a
casualty of over 16,600 people worldwide with more than 380,000 people confirmed as infected by it,
of which more than 10,000 cases are serious. Mainly based on Chinese newspapers, social media
and other digital platform data, this paper analyzes the timeline of the key actions taken by the
government and people over three months in five different phases. It found that although there was
an initial delay in responding, a unique combination of strong governance, strict regulation, strong
community vigilance and citizen participation, and wise use of big data and digital technologies, were
some of the key factors in China’s efforts to combat this virus. Being inviable and non-measurable
(unlike radioactive exposure), appropriate and timely information is very important to form the basic
foundation of mitigation and curative measures. Infodemic, as it is termed by WHO, is a key word,
where different stakeholder’s participation, along with stricter regulation, is required to reduce the
impact of fake news in this information age and social media. Although different countries will need
different approaches, focusing on its humanitarian nature and addressing infodemic issues are the
two critical factors for future global mitigation efforts.

Keywords: COVID-19; Coronavirus; infodemic; humanitarian emergency; data science; good

governance; citizen participation

1. Introduction
Coronavirus (COVID-19) started spreading in December 2019 and was noticed in early January
2020. It started spreading in China in mid- to late-January. Among the different types of confusion
and information challenges, we need to recognize that COVID-19 is first and foremost a humanitarian
challenge [1]. As of 24 March, 2020, the virus has caused the death of over 16,600 people worldwide
with more than 380,000 people are confirmed as infected by it, of which more than 10,000 are serious.
As many as 184 out of 195 countries are affected. Solving the humanitarian challenge is the key priority
through proper preventive measures to stop its spread, as well as curative measure to develop a
vaccine. The impact of this public health emergency has affected countries and communities in terms
of economic, socio-psychological issues, as well as international relations.
“We’re not just fighting an epidemic; we’re fighting an infodemic”, said WHO Director–General
Tedros Adhanom Ghebreyesus at the Munich Security Conference on 15 February 2020. WHO
Information Network for Epidemics (EPI-WIN) was launched as a new information platform after
WHO declared COVID-19 as a Public Health Emergency of International Concern (PHEIC). The goal

Int. J. Environ. Res. Public Health 2020, 17, 2309; doi:10.3390/ijerph17072309 www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020, 17, 2309 2 of 12

was to share customized information with specific target groups [2]. Finally, on 11th March, WHO
declared it this as a pandemic.
“We know that every outbreak will be accompanied by a kind of tsunami of information, but also
within this information you always have misinformation, rumors, etc. We know that even in the Middle
Ages there was this phenomenon. “But the difference now with social media is that this phenomenon
is amplified, it goes faster and further, like the viruses that travel with people and go faster and further.
So it is a new challenge, and the challenge is the [timing] because you need to be faster if you want
to fill the void...What is at stake during an outbreak is making sure people will do the right thing to
control the disease or to mitigate its impact. So it is not only information to make sure people are
informed; it is also making sure people are informed to act appropriately.” Said Sylvie Briand, Director
of Infectious Hazards Management at WHO’s Health Emergencies Program and architect of WHO’s
strategy to counter the infodemic risk. This poses the real challenge of mitigating the risk occurring
from Coronavirus.
One of the key issues of the “invisible disaster” is obtaining correct information. In 2011, Japan
had a triple disaster, caused by an earthquake-induced tsunami, which caused a nuclear meltdown.
A that time, there was a severe panic in and around Japan about the level of radiation, which was also
an invisible disaster. However, radiation could be measured, whereas the level of penetration of the
virus is not measurable. Therefore, providing the right information from a reliable source is the key
issue in this type of pandemic.
Keeping this infodemic challenge in mind, this paper tries to analyze three months of happenings
in China from December 2019 to February 2020, drawing and analyzing data from different Chinese
websites, social media and research institutes. The value addition of this paper lies in the fact that
original data were collected and analyzed in Chinese, and from Chinese social media. Although a
characteristic information censorship exists in China, there were several positive and negative things
that happened in the last three months. This paper is a narrative of those events and provides an
original analysis.
There are three characteristics/impacts of the paper: (1) this is possibly the first analytical paper
which uses firsthand social media and internet data and information from China to describe the
time-series narrative in Wuhan and China with a focus on key policy decision, (2) it also uses original
survey raw data to understand the types of media people used to get information, and (3) the reliance
of different types of online services at different phases of the lockdown.
Of course, the paper has its own limitation, since, due to the evolving nature of the pandemic, the
paper analyzes the spread in the original hotspot (although, as of late March 2020, the hotspot has
shifted to Europe), which was Wuhan and the Hubei province of China. However, the key findings,
which are described in Section 5, are useful to other parts of the world, which is currently suffering the
impacts of COVID-19, as well as in future pandemic responses.

2. Characteristic of COVID-19
The data on Coronavirus are changing on daily basis, and it is difficult to provide current statistics
for the affected, recovered and casualties. However, based on some initial studies, a few characteristics
are emerging for this virus. It is reported that the case-fatality-rate (CFR) for Coronavirus was 2.3%,
initially; however, the age group of 70 to 79 has an 8% CFR, and CFR is 14.6% for those more than 80
years old [3]. This means that the virus has a stronger impact on the aged population.
The other characteristic of the virus is its speed in spreading. When Dr. Zhong Nan Shan made a
public announcement of this virus in CCTV on the 20th of January, the virus had already spread in
different provinces in China, as well as outside China. Every day, some new countries are added to the
list, which has already reached more than 100 countries and regions. It took only 30 days to spread
from one city to the entire country of China. The early cases may have been spread from the Wuhan
seafood market, while later cases were spread from person to person, the speed of which surprised
the health workers in Wuhan city and Hubei province. The epidemic curve shown in [4] as well as
Int. J. Environ. Res. Public Health 2020, 17, 2309 3 of 12

presented later in this paper, shows that the second to the third week of January was the most crucial
time, when the spread was very high.
There are some similarities and differences among COVID-19, Severe Acute Respiratory Syndrome:
2002–2003 (SARS) and Middle East Respiratory Syndrome: 2012-ongoing (MARS). SARS also had a
zoonotic transmission in markets in Guangdong Province, China. It is said that COVID-19 is likely
to have been transmitted from bats via palm civets. Similarly, MERS was also traced to zoonotic
transmission of a novel coronavirus (likely from bats via dromedary camels) in Saudi Arabia. All three
viruses have similar syndromes like fever and cough, which frequently lead to lower respiratory tract
disease. However, SARS has a higher CFR of 9.6%, while MARS is even higher at a rate of 34.4%.
Despite much higher CFRs for SARS and MERS, COVID-19 has led to more total deaths due to the
large number of cases.
Projection shows a significant recession in the global economy due to Coronavirus spread [1].
The global surge reflects a new inflection point in this epidemic. Four ‘major transmission complexes’
(i.e., China, East Asia, Middle East, Europe) are now active, while the US is already at a tipping point.
The analysis says that continued spread within established complexes plus community transmission in
new complexes drives a ~0.3%–0.7% reduction in 2020 global GDP growth. The impact on demand
slows down the growth of the global economy by between 1.8%–2.2%, instead of the 2.5% growth
envisioned at the start of the year. Sectors are impacted differently. Certain sectors (e.g., aviation,
tourism, hospitality) see lower demand for a longer duration. For others (e.g., consumer goods),
demand is initially lower but expected to rebound quickly. The report also argues that 24th of February
2020 was a turning point, when the cases outside Chine exceeded in-China cases for the first time. South
Korea, Italy, Iran, Japan and Singapore are the top five countries outside China which have reported a
maximum number of cases, with Iran reporting the largest number of casualties outside China.

3. Data Source and Methodology

To focus on the key word “information”, which is crucial for any invisible disaster, a series of
different types of data were analyzed. Primary data sources include:
(1) Sina Weibo’s (Chinese social media) hot search list (in which a key word has been accessed
every day for how many times as well as how many hours) [5]
(2) Corona Virus timeline data in China (which are compiled by the authors from different
data sources like Sina, Tiki-Toki, Caixin, Baidu, Tencent and provincial and municipal government
data) [6–21]
(3) CSM media research data on the use of different types of media to acquire information [22,
23]; and
(4) Mob-Tech Research Institute data of use of internet during the Corona virus spread [24,25].
Four specific types of analysis were made based on the above-mentioned data sources:

(a) Timeline narrative, number of affected people and public concern: The timeline narrative is
developed based on the sequential events in the country, and important measures taken, which is
also juxtaposed to the major public concerns. Weibo’s data (2020) have been analyzed for the top
206 to 360 hits per topic (depends on the daily variation) over a period of three months, from
1 December 2019 to 1 March 2020 [24]. Tiki-Toki’s data [9] is the Chinese government big data
platform, and provides information on different government measures, news, policies, and also is
linked to major global milestones in the related topic (here, Coronavirus-related topics). Sina’s
data was on (1) the number of affected people (confirmed cases, recovery, and death) at both the
country level and in Hubei province, (2) Sina Weibo data to analyze social media information.
Figure 1a,b show the growth in the number of affected and recovered people and casualties in
Hubei province and the whole of China, which is referred to in a later section. Figure 2 was also
prepared as an original diagram to highlight different phases of this disaster. Specific attention
was made on the day to day changes in numbers, any significant policy actions taken, and
any significant incidence (positive or negative) reported on social media or a website. Social
Int. J. Environ. Res. Public Health 2020, 17, 2309 4 of 12

media/website information (both government official sites as well private sites) were used to
draw the timeseries narrative. Word Cloud analysis was made using the key words used in
social media for all the five phases mentioned in the text, and the top five most commonly used
words are picked to highlight the key discussion in the social media, as well as to understand
citizens’ agony.
(b) Media use during/after Coronavirus spread and information types: This is mainly derived
from the analysis of [23] on February 20–21, 2020, with more than 1500 residents from all 31
provinces in China, to understand the use of media to acquire information related to Corona
virus. The analysis used the data of CSM survey to draw original graphs and diagrams with
its interpretation;
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW 4 of 12
(c) Positive impact on certain online industries: The data from [24] are based on the analysis of 2019
and 2020 (positive
analysis, or but
negative) reportedintensive
more specific on socialanalysis
media orof athe
website. Social
use of the media/website
internet during the period
information (both government official sites as well private sites) were used to draw the
of 22 January 2020 to 6 February 2020. These data were used to understand the proliferation of
timeseries narrative. Word Cloud analysis was made using the key words used in social
certain online services compared to others, which is correlated to people’s interest in different
media for all the five phases mentioned in the text, and the top five most commonly
topics available
used words online.
are picked to highlight the key discussion in the social media, as well as to
understand citizens’ agony.

Figure 1. (a) Number of people affected, recovered, and dead in China and Hubei province; (b) New
Figure 1a. Number of people affected, recovered, and dead in China and Hubei province; Figure 1b.
confirmed and recovered cases in China and Hubei province; (Source: these graphs were prepared by
New confirmed and recovered cases in China and Hubei province; (Source: these graphs were
the authors
prepared by using original
the authors data
using from:data
original Sina News
from: Sina[5]).
News [5]).

b) Media use during/after Coronavirus spread and information types: This is mainly
derived from the analysis of [23] on February 20–21, 2020, with more than 1500 residents
from all 31 provinces in China, to understand the use of media to acquire information
related to Corona virus. The analysis used the data of CSM survey to draw original
graphs and diagrams with its interpretation;
c) Positive impact on certain online industries: The data from [24] are based on the
 4. Criticism, agony and depression phase: Until 14 February 2020;
5. Positive prevention and curative control phase: Until 29 February 2020.
Figure 2 shows the timeline of key events in five phases. Authors extracted the key events from
different news and social media reports. In each phase, five top public concerns are highlighted,
which is prepared through word cloud analysis in each phase using the key social media data, as
Int. J. Environ. Res. Public Health 2020, 17, 2309 5 of 12
specified in the methodology section.

1st December 2019 - Unknown virus

First case reproted in Wuhan
Very early phase
(~31st December 2019)
1st January 2019
Seafood market in Wuhan closed
20th January 2020
- Wuhan
30th December 2019 - Female
Dr. Li first reported the disease - New year
- Observation
- Coronavirus
Dec 31-Jan 4, Jan 8-16, - Wuhan
Jan 18-19,2020 - Confirmed case

Public Concern
- CCTV new year program
Investigation phase Dr. Zhong Nan Shan made Central govt team visit - Zhong Nana Shan (Doctor)
(~20th January 2020) announcement in CCTV
22nd January 2020 28th January 2020 - Pneumonia
Hubei province announced emergency Supreme court decision on fake news - Confirmed case
- Coronavirus
Early 23rd, 25th January 2020 - Epidemic
30th January 2020
intensification phase Hospital construction started - Wuhan
(~31st January 2020)
WHO announced PHEIC
- Wuhan
2nd February 2020 3rd February 2020 - Zhong Nana Shan (Doctor)
Hospital completed, handed over City sanitization started - Li Wen Liang
- Confirmed case
Criticism, agony and
7th February 2020 5th February 2020 - Mask / Shuanghuang Lian
depression phase (medicine mentioned in People’s Daily)
(~14th February 2020) Dr. Li passed away forced door to door checking started

15th February 2020 - Pneumonia

Public life in Wuhan was published 18th February 2020 - Confirmed case
QR code was introduced - Zhong Nana Shan (Doctor)
- Wuhan
Positive prevention and - Epidemic
20th February 2020 26th February 2020
curative control phase
Death of young doctor Overseas Chinese were prohibited
(~29th February 2020)

Figure 2. Timeline
Figure of key
2. Timeline events
of key eventsand
andpublic
public concern; (Source:This
concern; (Source: This figure
figure waswas prepared
prepared byauthors
by the the authors
usingusing
original datadata
original from: Sina,
from: Tiki-Toki,
Sina, Tiki-Toki,Caixin,
Caixin, Baidu: [6–21]).
Baidu: [6-21]).

4. Data Analysis
4.1.1. and
Very Early Key Until
Phase: Findings
31 December, 2019
As per
4.1. Narrative onthe
theavailable statistics,
Events and the earliest
Its Response case was reported on 1 December, 2019 in Wuhan, and
Sequence
thereafter sporadic cases have been reported all through December, especially in the later part of the
To develop
month. The this
first narrative, as mentioned
case was reported above,
in a paper [26] aon
large number
1st of Decemberof sources
2019. Thewere consulted,
health reviewed
commission
of Wuhan
and some municipality
milestones eventsreported the first case
are presented of Needless
here. Coronavirus to (at
say,the time,a an
with unusual
vast countrydisease). These with
like China,
wereofunusual
the level cases,
infection which took
of Corona thethere
Virus, local are
physicians by surprise,
many small and it was
yet important Dr. Liwhich
events, Wen Liang
may bewho
missed
reported the unusual case as a possible epidemic in WeChat social media on 30th
out here. However, the author tried to highlight the key developments in China based on the five of December 2019.
following phases:

1. Very early phase: Until 31 December 2019;

2. Investigation phase: Until 20 January 2020;
3. Early intensification phase: Until 31 January 2020;
4. Criticism, agony and depression phase: Until 14 February 2020;
5. Positive prevention and curative control phase: Until 29 February 2020.

Figure 2 shows the timeline of key events in five phases. Authors extracted the key events from
different news and social media reports. In each phase, five top public concerns are highlighted, which
is prepared through word cloud analysis in each phase using the key social media data, as specified in
the methodology section.

4.1.1. Very Early Phase: Until 31 December, 2019

As per the available statistics, the earliest case was reported on 1 December, 2019 in Wuhan, and
thereafter sporadic cases have been reported all through December, especially in the later part of the
month. The first case was reported in a paper [26] on 1st of December 2019. The health commission of
Wuhan municipality reported the first case of Coronavirus (at the time, an unusual disease). These
were unusual cases, which took the local physicians by surprise, and it was Dr. Li Wen Liang who
reported the unusual case as a possible epidemic in WeChat social media on 30th of December 2019.

4.1.2. Investigation Phase: Until 20 January 2020

This phase was characterized by a crackdown by local government and detailed investigation.
Huanan seafood market in Wuhan city was closed on 1st of January. The city government and its
Int. J. Environ. Res. Public Health 2020, 17, 2309 6 of 12

health commission investigated the cases in December and called Dr. Li and made him apologize for
spreading a rumor on the 31st of December 2019. Three teams of experts from Beijing conducted a
detailed investigation from the 31st December to 4th January, 8–16 January and 18–19 January. It was
revealed that the disease was a new type of epidemic, which had not been reported earlier. This was
announced on 20th of January by a major and well-known doctor, Dr. Zhong Nan Shan, in a CCTV
online interview.

4.1.3. Early Intensification Phase: Until 31 January 2020

This was a critical period, when the disease spread was intensified and a relatively large number
of casualties was observed. Figure 1a shows the number of people affected, recovered and dead in
China and Hubei province, and Figure 1b shows the new confirmed and recovered cases in China and
Hubei province. At an early part of this phase, a few critical and wise decisions were made:
22nd January: Hubei province announced a Level II public emergency;
23rd of January: Wuhan city was closed and all the entries and exits to the city were restricted.
The decision to construct Huoshenshan Hospital (new hospital) for Corona virus cases was announced
on this day (23rd January), followed the decision to construct Leishenshan Hospital (another new
hospital) decision on 25th January. Ten hospitals in Wuhan city appealed for a supply of medical and
other emergency goods from all over the country;
24th January: Hubei province followed the suit, and the whole province was closed for entrance
and exit. Hubei, Beijing, Shanghai and eight other provinces declared a public emergency;
25th January: The Supreme court provided instruction on “Fake news” and the negative
consequences of this. Tencent, which is the parent company of WeChat, established a website called
“Rumors exposed website,” as a platform to reduce rumors;
26th of January: The first emergency supply arrived from Sichuan to Wuhan, along with medical
and healthcare staff;
28th January: President Xi Xinping met WHO DG Dr. Tedros Adhanom Ghebreyesus and discussed
the situation. China Media administration instructed all TV channels to reduce entertainment programs,
and to increase broadcasting information and programs on Coronavirus and related news;
29th January: A countrywide emergency was declared;
30th January: The Emergency Committee on the novel coronavirus (2019-nCoV) under the
International Health Regulations (IHR 2005) was reconvened by the World Health Organization
Director–General Dr Tedros Adhanom Ghebreyesus on 30th January (Geneva time) and a Public Health
Emergency of International Concern (PHEIC) was declared;
31st January: People’s Daily, the major Chinese newspaper’ official account, published fake news
on a possible medicine (named Shuang Huang Lian, a Chinese antibiotic, of which online orders and
users have drastically increased) for Coronavirus by mistake, which caused the panic-buying of the
medicine by the public.

4.1.4. Criticism, Agony, Depression and Control Phase: Until 14 February 2020
The next phase was a phase of panic, criticism, agony and sad news. The following events took
place that explain this phase:
31st January: Public criticism started on Chinese social media regarding the outbreak of the virus;
1st February: People’s Daily corrected their mistake regarding the fake news. A major media site,
Caixin data analysis, showed that public agony had increased and people were growing worried about
the future spread of the virus;
2nd February: The new hospital was prepared and handed over to the Army to take control;
3rd February: Sanitization of public spaces started, school entrance examinations were cancelled,
and another new hospital was ready;
4–6th February: This was a time of control, where a few major control measures were taken. like a
lockdown of villages, towns and cities (earlier, this was restricted to urban areas only). A new policy of
Int. J. Environ. Res. Public Health 2020, 17, 2309 7 of 12

“no one will be spared” was started (this enabled the government to enter people’s house and check
for virus symptoms). Dou Ban, a major media group, was shut down. Overseas news, especially the
spread of Coronavirus in a cruise ship in Japan (Diamond Princess) was broadcast in China through
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW 7 of 12
different media;
7th February: 3rdThe firstSanitization
February: whistleblower of publicfrom
spacesWuhan, Dr.entrance
started, school Li, passed away,were
examinations andcancelled,
this caused severe
public criticism in social media. This was followed by a depression phase, where several suicides by
and another new hospital was ready;
4–6th February: This was a time of control, where a few major control measures were taken. like
the infected people were observed, to save their respective family members;
a lockdown of villages, towns and cities (earlier, this was restricted to urban areas only). A new policy
9th February:
of “no one Thewill Center of Disease
be spared” was started Control (CDC)
(this enabled the head gavetoan
government online
enter interview
people’s house and with Caixin
and announced check thatforthe
virus symptoms).
virus Dou Ban,
is a totally newa type,
major ofmedia
whichgroup,notwas shut is
much down. Overseas
known yet.news,
especially the spread of Coronavirus in a cruise ship in Japan (Diamond Princess) was broadcast in
There were several incidences of sacking senior administration people; the China News head
China through different media;
was sacked for spreading
7th February: wrong
The firstinformation
whistleblower (12th February)
from Wuhan, Dr. Li, and Wuhan’s
passed away, and Mayor was
this caused replaced (13th
severe
public criticism
February). Holidays (school in social media.
as well asThis was followed
offices) were by a depression phase, where several suicides by
extended.
the infected people were observed, to save their respective family members;
9th February: The Center of Disease Control (CDC) head gave an online interview with Caixin
4.1.5. Positive Prevention and Curative Control Phase: Until 29 February 2020
and announced that the virus is a totally new type, of which not much is known yet.
There were several incidences of sacking senior administration people; the China News head
The following phase was a time of positive prevention and curative planning. Several new
was sacked for spreading wrong information (12th February) and Wuhan’s Mayor was replaced (13th
initiatives were taken through(school
February). Holidays media to address
as well public
as offices) were criticism as well as to lessen public agony:
extended.
15th February: A diary of public life in Wuhan was broadcast and shared through social media;
4.1.5. Positive Prevention and Curative Control Phase: Until 29 February 2020
18th February: A touching story of female nurses cutting their hair to cope with the continuous
The following phase was a time of positive prevention and curative planning. Several new initiatives
work with protective suits was broadcast in the mass media as well as on social media. Dead bodies
were taken through media to address public criticism as well as to lessen public agony:
post-mortem had15th started to identify
February: the key
A diary of public life medical factors
in Wuhan was andand
broadcast impacts on thesocial
shared through body. On the 18th of
media;
February, a unique approach
18th February: Aoftouching
using astory
QRofcode
femalewas adopted
nurses in Wuhan
cutting their and
hair to cope then
with spread to other parts
the continuous
work with protective suits was broadcast in the mass media as well as on social media. Dead bodies
of Hubei province using mobility and safety of the person (in terms of effect of Corona virus). This QR
post-mortem had started to identify the key medical factors and impacts on the body. On the 18th of
code was usedFebruary,
for public transport,
a unique approachentering
of using a public
QR codeareas. Using
was adopted in big
Wuhandata
andin mobile
then spreadphones,
to other three color
parts of
coding were used Hubei province
(Figure using
3): green mobility
(safe), and safety
yellow (needof the
toperson (in terms ofand
be cautious), effectred
of Corona
(cannot virus).
enter). Printed
This QR code was used for public transport, entering public areas. Using big data in mobile phones,
QR codes were used for the people who did not have mobile phones (like elderly people or children).
three color coding were used (Figure 3): green (safe), yellow (need to be cautious), and red (cannot
On 19th of February, the “no
enter). Printed one will
QR codes were be
usedspared” policy
for the people whowasdid ended.
not have mobile phones (like elderly
people or children). On 19th of February, the “no one will be spared” policy was ended.

Figure 3. Three color codes used

Figure for monitoring
3. Three color codes usedpeople’s movement
for monitoring (Source: https://www.sina.com.
people’s movement
(Source: https://www.sina.com.cn [5]).
cn [5]).
20th February: A newlywed young doctor passed away, which also created negative sentiment
20th February: A newlywed
in social media. The issues young doctor
of vulnerable passed
people like theaway, which also
aged population (11 of created
them diednegative
in an old sentiment
in social media. The issues of vulnerable people like the aged population (11 of them died in an old
people’s home in Wuhan, along with the caregiver, which came out in the news on 20th February),
people’s home physically and mentally
in Wuhan, alongchallenged
with thepeople, and theirwhich
caregiver, caregivers,
came received
out attention in the media;
in the news on 20th February),
physically and mentally challenged people, and their caregivers, received attention in the media;
21st and 22nd February: Data management and its authentication was re-ensured on (Jingzhou
city), and goods distribution was re-investigated to ensure a balanced distribution (after a TikTok video
which pointed out the imbalance in some areas). Punitive measures were taken for the two leaders of
Hubei province for hiding information (22nd February);
 Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW 8 of 12

Int. J. Environ. Res. Public Health 2020, 17, 2309 8 of 12

21st and 22nd February: Data management and its authentication was re-ensured on (Jingzhou
city), and goods distribution was re-investigated to ensure a balanced distribution (after a TikTok
video
23rdwhich pointed
February: Theout
lastthe imbalance
half in some
of this phase wasareas). Punitive
marked measures
by mixed were ensuring
measures: taken forthe
thefree
twoflow
leaders of Hubei province for hiding information (22nd February);
of emergency goods and food and punishing those prohibited them (23rd February), and the death of
23rd February: The last half of this phase was marked by mixed measures: ensuring the free flow
two additional health professionals (23rd February);
of emergency goods and food and punishing those prohibited them (23rd February), and the death
26th February: New infection due to the return of overseas Chinese people in some
of two additional health professionals (23rd February);
selected provinces;
26th February: New infection due to the return of overseas Chinese people in some selected
28th February: The unfortunate incidence of drinking sanitization tablet by mistake by some rural
provinces;
people,28th
caused healthThe
February: issues, and thereincidence
unfortunate was another unfortunate
of drinking incidence
sanitization of by
tablet suicide of abyjunior
mistake somehigh
school
ruralkid whocaused
people, did not haveissues,
health a mobile
andphone to undertake
there was online classes
another unfortunate provided
incidence by schools.
of suicide of a junior
high school kid who did not have a mobile phone to undertake online classes provided by schools.
4.2. Media Use during/after Coronavirus Spread and Information Types
4.2.As
Media Use during/after
mentioned above, anCoronavirus
analysis Spread and Information
was done by CSM MediaTypesResearch with 1500 residents all over
China onAs the mobileabove,
mentioned they use to accesswas
an analysis different
done bysites.
CSMFigure
Media 4 shows different
Research with 1500media usage
residents on four
all over
different aspects:
China on increased
the mobile usage
they use after different
to access Coronavirus
sites. spread,
Figure 4same
showsuse as before,
different media less use than
usage before
on four
anddifferent
do not aspects:
use it forincreased
6 months.usage after Coronavirus
Analysis shows that spread,
WeChatsame
and use as before,
TV played less userole
a strong than
inbefore
acquiring
and do not after
information use it Coronavirus
for 6 months. Analysis
spread. shows that WeChat
The amount and TV played
of applications a strong
has also role in acquiring
increased compared to
information
other after Coronavirus
media usage, spread.
since it provides The amount
real-time of applications has also increased compared to
information.
other media usage, since it provides real-time information.

Live / APP

Radio

Audio APP

Weibo

Business news (portal site and APP)

Movie / Portal site/ APP

Traditional media

Short movie / APP (TikTOK)

TV

Wechat

0 20 40 60 80 100

Figure
Figure 4. 4.Use
Useofofdifferent
differenttypes
types of
of media
mediabefore
beforeand
andafter
afterthe Coronavirus
the spread;
Coronavirus (Source:
spread; this this
(Source: figure
figure
was
was preparedbybythe
prepared theauthors
authorsusing
using original
original data
datafrom:
from:CSM
CSMMedia Research
Media Research[23]).
[23]).

The
The surveyalso
survey alsopointed
pointed out
out that
that 44%
44%people
peoplesought
soughttoto
proactively secure
proactively information,
secure information,followed
followed
thethe news
news and
and put
put inin their
their favorites.AAtotal
favorites. totalofof33%
33%viewed
viewedthetheinformation
information proactively,
proactively, but
but did
did not
not put
put it into their favorite news items. A total of 19% people saw the information if it
it into their favorite news items. A total of 19% people saw the information if it was in the news orwas in the news
or media; 2% of people did not bother to take any additional actions for information gathering, while
media; 2% of people did not bother to take any additional actions for information gathering, while
another 2% did not want to hear the negative news on Coronavirus.
another 2% did not want to hear the negative news on Coronavirus.
Figure 5 shows the types of information accessed by different users through online platforms. It
Figure 5 shows the types of information accessed by different users through online platforms.
shows that the maximum access was to get information on medicines, followed by a set of other
It shows that the maximum access was to get information on medicines, followed by a set of other
information like food/drink, online education, in-house sports, business information and
information like and
entertainment food/drink, onlineThis
leisure goods. education,
shows the in-house sports,
lifestyle businesswhen
requirements information and isolated
people were entertainment
in
and leisure goods. This shows the
their home for a long period of time. lifestyle requirements when people were isolated in their home for a
long period of time.
Int. J. Environ. Res. Public Health 2020, 17, 2309 9 of 12
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW 9 of 12

Others 0.3

Accessories 4.5

Toys 5.8

Kids and pregnancy goods 8.5

Ticket (refund etc.) 8.7

Car 8.8

Electrical appliances 10.3

Cosmetics 11.7

Games (downloads) 11.9

Fashion 12.1

Digital goods 13.9

Tr avel and leisure information 15.1

Inter net application 16.1

Novel and books 18.3

Entertainment and leisure goods 25.9

Business i nformati on 28

In-house sports equipm ents 28.3

Online education 29.4

Food and drinks 29.4

Medicine and supplements 47.6

0 5 10 15 20 25 30 35 40 45 50

Figure
Figure 5. Types
5. Types of informationneeded
of information needed by
by people
peoplethrough online
through platforms;
online (Source:
platforms; this figure
(Source: was was
this figure
prepared by the authors using original data from: CSM Media Research
prepared by the authors using original data from: CSM Media Research [23]). [23]).

4.3. Positive
4.3. Positive impact
Impact onon certainOnline
Certain online industries
Industries
As seen
As seen in Figure
in Figure 5, 5,medicine,
medicine, food food supply
supplyand andonline
onlineeducation
educationwere the top
were thesearched items. items.
top searched
Online food supply users have drastically increased by 10 million, with an increase of 10.60 million
Online food supply users have drastically increased by 10 million, with an increase of 10.60 million in
in delivery capacity (by volume) when comparing the data of online food shopping of January 2019
delivery capacity (by volume) when comparing the data of online food shopping of January 2019 with
with that of January 2020. A significant increase is observed in users with the age group 35 to 44 years,
that from
of January 2020. A 2019)
27.9% (January significant
to 45.1%increase
(Januaryis 2020).
observed in users
Specific with
increase the
has agenoted
been group 35 households
with to 44 years, from
27.9% (January
with children2019)
fromto0 45.1% (January
to 3 years 2020).
old (from 7.2Specific increase
% of January 2019has
to been
25.2 %noted with households
in January 2020). The with
children fromdata
available 0 toshow
3 years
thatoldfour(from
major7.2 % of food
online January 2019
supply to 25.2 %have
companies in January
increased2020).
their The available
delivery
datacapacity
show thatby afour majorpercentage.
significant online food Theysupply
are ascompanies
follows: Hema have increased
Fresh (up by 50%their delivery
compared capacity by
to before
the virus spread),
a significant percentage.Miss Fresh
They (up areby as321% compared
follows: HematoFresh
January(up2019), Dingdong
by 50% comparedMaicaito(up by 300%
before the virus
from Miss
spread), December
Fresh2019),
(up by and
321%Jing compared
dong Daojia to (up by 470%
January 2019),compared
Dingdong to January
Maicai 2019).
(up byAll300%the from
companies are struggling with a lack of human resources and shared their
December 2019), and Jing dong Daojia (up by 470% compared to January 2019). All the companies employees to help each
other, which delayed delivery in several cases.
are struggling with a lack of human resources and shared their employees to help each other, which
Online education has also seen significant changes. On 27 January 2020, the Central Government
delayed delivery in several cases.
Education Ministry has declared to postpone the start of classes until after the spring vacation. There
Online
was education
an instant rise inhas alsoeducation
online seen significant
(Xueersi changes. On 27
online internet January
school) after2020,
that, the Central
which saw a Government
drastic
Education
increase by twenty-fold from 0.52 million to 11.54 million users within a period of onevacation.
Ministry has declared to postpone the start of classes until after the spring week (28 There
was January
an instant
to 6rise in online
February, education (Xueersi online internet school) after that, which saw a drastic
2020).
increase by twenty-fold from 0.52 million to 11.54 million users within a period of one week (28 January
5. Key Learning
to 6 February, 2020).and Postscripts
Through the Susceptible-Exposed-Infectious-Removed (SEIR) model and AI, [27] found that the
5. Key Learning
epidemic and Postscripts
of China should peak by late February, showing a gradual decline by the end of April. A
five-day
Through delay
the inSusceptible-Exposed-Infectious-Removed
implementation would have increased the epidemic
(SEIR)size in mainland
model and AI,China
[27] three-
found that
fold. Lifting the Hubei quarantine would lead to a second epidemic peak in Hubei province in mid-
the epidemic of China should peak by late February, showing a gradual decline by the end of
March and extend the epidemic to late April, a result corroborated by the machine learning
April. A five-day delay in implementation would have increased the epidemic size in mainland
prediction.
China three-fold. Lifting
WHO, in a recent thestudy
joint Hubei
withquarantine would has
Chinese colleagues, leadsummarized
to a second epidemic
four peak
specific key in Hubei
lessons
province in mid-March
as follows [3]: and extend the epidemic to late April, a result corroborated by the machine
learning prediction.
WHO, in a recent joint study with Chinese colleagues, has summarized four specific key lessons
as follows [3]:
Int. J. Environ. Res. Public Health 2020, 17, 2309 10 of 12

1. China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort
in history. Although initially quite aggressive, gradually, a science and risk-based approach was
taken to tailor its implementation;
2. Achieving China’s exceptional coverage with adherence to these containment measures has only
been possible due to the deep commitment of the Chinese people to collective action in the face
of this common threat. At a community level, this is reflected in the remarkable solidarity of
provinces and cities in support of the most vulnerable populations and communities;
3. China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed
the course of a rapidly escalating and deadly epidemic;
4. China is already, and rightfully, working to bolster its economy, reopen its schools and return
to a more normal semblance of its society, even as it works to contain the remaining chains of
COVID-19 transmission.

From our own analysis, it was observed that the success of China’s efforts in controlling the
disease was a combination of strong governance, strict regulation and spontaneous community/citizen
participation. Although it was a late response in terms of the local and provincial government at the
initial stage, once the disease was confirmed as a new one, collective responses at the community,
ward, city, province and national levels were significant. To keep this large a number of people
confined in their homes for almost two months was not an easy decision in terms of both economic
and socio-psychological aspects. China’s mobile network and big data system was able to create the
QR code-screening of people, which can be considered a significant achievement. As mentioned in
the earlier part of this paper, WHO DG has termed this virus spread as infodemic; having the right
information was key to the success of mitigation measures. At an early stage, The Supreme Court’s
directives on fake news were a very good step in this regard to reduce the spread of confusion and
panic. The “Rumors exposed website” created by Tencent (the parent company of WeChat) helped
to share information on fake news and rumors effectively. Whenever there was fake news published
or some mismanagement happened with the emergency goods and food supplies, quick corrective
measures were taken by the authorities. At the village level, local communities and volunteers worked
hard to ensure the implementation of the mitigation measures to reduce the spread as well as to report
confirmed or suspected cases. At an early stage, data management was an issue, but once the virus
was confirmed and declared by the government, strict data management measures were put into place.
In this case, strict corrective measures were ensured for the mismanagement of data. The current case
needs a science based solutions with local action [28].
These lessons are also reflected in the WHO research roadmap [29], where eight specific research
issues have been identified with a balance of medical diagnosis and community use. It also emphasized
social science research in the outbreak response, where the WHO will establish a team that will be
integrated within multidisciplinary research and operational platforms and will connect with existing
and expanded global networks of social sciences. As per [30], governments will not be able to minimize
deaths from coronavirus disease 2019 (COVID-19) and the economic impact of viral spread. Keeping
mortality as low as possible will be the highest priority for individuals; hence governments must
put measures in place to ameliorate the inevitable economic downturn. In our view, COVID-19 has
developed into a pandemic, with small chains of transmission in many countries and large chains
resulting in extensive spread in a few countries, such as Italy, Iran, South Korea, and Japan. Most
countries are likely to have a spread of COVID-19, at least in the early stages, before any mitigation
measures have an impact [30].
As we started the paper with two key words “humanitarian challenge” and infodemic, we would
like to once again highlight that basic humanitarian principles need to be followed in this type of
emergency. Of course, there are geo-political, economic and social consequences, which also need
to be looked at. However, humanitarian issues need to prevail over other priorities. The second
point is that Coronavirus is a non-measurable disaster, unlike other invisible disasters like radioactive
emission. Therefore, having correct and timely information is crucial for stopping its spread, as well as
Int. J. Environ. Res. Public Health 2020, 17, 2309 11 of 12

in the curative prevention of this disease. These two factors, along with good governance and citizen
participation, will hold the key to success in combatting Coronavirus in future.

Author Contributions: Conceptualization and methodology was done by R.S., data collection and analysis was
done by J.H., writing was jointly done by R.S. and J.H. All authors have read and agreed to the published version
of the manuscript.
Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflict of interest.

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